特比萘芬治疗老年糖尿病患者趾甲真菌病疗效观察

Clinical efficacy of terbinafine in treatment of toenail onychomycosis in elderly diabetic patients

目的观察应用时间对特比萘芬治疗趾甲真菌病的疗效和安全性。方法将84例老年糖尿病趾甲真菌病患者随机分为两组，均口服特比萘芬250mg／d，观察组共治疗16周，对照组12周。停药后24周观察疗效。结果观察组治愈率68．2％，高于对照组40．0％（x^2=6．71，P〈0．01）；观察组显效率为86．4％，高于对照组的67．5％（X^2=4．26，P〈0．05）。真菌治愈率观察组为93．2％，对照组为77．4％，观察组优于对照组（x^2=4．21，P〈0．05）。在停药52周时，观察组30例中复发2例，对照组16例中复发6例，差异有统计学意义（x^2=4．93，P〈0．05）。结论应用时间影响特比萘芬治疗趾甲真菌病的效果。应用时间长，治愈率高，复发率低。

Objective To observe effect of treatment time of terbinafine on the efficacy and safety for toenail onychomycosis in elderly diabetie patients. Methods Eighty-four cases of senile diabetic patients with onychomycosis were randomly divided into two groups, and treated with oral terbinafine 250 mg daily. The experimental group was treated for 16 weeks. The control group was done for 12 weeks. The withdrawal effect was evaluated after 24 weeks. Results The cure rate of treatment group was 68.2%, and the efficiency was 86.4%. The cure rate of control group was 40.0%, and the efficiency was 67.5%. The cure rate and efficiency between treatment group and the control group had significant difference （X^2 = 6.71, P 〈 0.01 X^2 = 4.26; P 〈 0.05 ）. Mycology clearance rate of treatment group was 93.2%, and control group was 77.4%. The cure rate of treatment group was significantly better than the control one（x^2 =4.21, P 〈0.05）. At the end of 52 weeks after drug withdrawal, only 2 cases of toenail onychomycosis recured in 30 cases in the treatment group, but 6 cases recured in 16 eases of onyehomycosis in the control. The recurrence rate was significantly different between the two groups （ X2 = 4.93, P 〈 0.05 ）. Conclusion Treatment time of terbinafine affects its efficacy for toenail mycosis. Long treatment period has high cure rate and low recurrence rate.